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Dr Phil: Scrotal lumps (video)

Hello there, I’m Dr Phil. Today we’re going to be talking about scrotal lumps. You’ll be pleased today that I won’t be examining my own scrotum – I think the sight of a 47-year-old GP’s scrotum is probably too much for your cornflakes, so I’m going to use these little accessories – my plums – oooh look, I’ve got a bit of a bruise on my plum already.

Now, the thing about your plums is that they come in a handy carrying sack called the scrotum, and in a healthy man your scrotum should look about 30 years older than you are. If you look roughly the same age as your scrotum, get some sleep: it’s a handy little test (little top tip there).
Now, the scrotal lumps that really matter are the ones that are actually within the plums themselves. If you examine your scrotum, probably best to do it after a hot shower when things are nice and relaxed and hanging down a bit, put them in the palm of your hand and you‘ll find that your plums should roughly weigh the same. In a lot of people one plum is slightly bigger than the other one but they should roughly weigh the same. In most men the left plum hangs down slightly lower than the right one. You sort of weigh them in the palm of your hand and then one at a time, just gently between thumb and fingers, just gently rotate them back: obviously not all the way round as they’ll come off. Most men aren’t very good at multiskilling so I say generally do one plum at a time. What you’re looking for is a lump within the plum itself, so not in the scrotum around the testicle but actually within the body of the testicle. And it will start often like a little grain of sand and you’ll think ‘oooh, little bit tender, that’s not quite right, like a grain of sand’, then it gets to the size of a pea and you think ‘oooh, that’s not quite right’. You should have gone to the doctor by then. What generally happens with blokes is they go ‘aaah, I’ve got a lump in my testicle, it’s embarrassing, it’s in my testicle, it’s a lump, that’s embarrassing’, and they let it get bigger. Then it get so big they think ‘the doctor’s going to think I’m a complete arse for having left it so long’ – I once saw a bloke whose testicle got to size of grapefruit because he was so embarrassed about having a lump. The lump will start as a grain of sand and if you get it at that early stage, it’s an easy job sorting it out: 96% of testicular cancer is cured these days. They bigger it gets, the more likely it is that they might have to remove a bit of your testicle, sometimes the whole testicle, but even then the chance of a cure is pretty good. So certainly grain of sand, great, if it’s the size of a pea, definitely you should be down the doctors.
Outside the testicle you have some tubes, some sperm collecting tubes, the epididymis, which feel a bit like al dente spaghetti. Sometimes it can get a bit like a bag of worms, you can get varicose veins around there and sometimes you get a little cyst there. If it’s very tender around the testicle you can get epididymitis, sometimes happens with a sexually transmitted infection. And then above, behind the epididymis and up, you’ve got the sperm collecting tube, that takes the sperm out. When you get to my age, 47, testicular cancer gets rarer, you get generally hernias in the testicle and your guts can come down into your scrotum. There’s a famous picture in a surgical textbook of a bloke whose entire gut came down through a hole, like a hole in a sock, into his inguinal canal, and he had his entire guts in his testicle. He had to push his entire scrotum around in a wheelbarrow: it’s a great photo, probably on the internet.
The bottom line is look after your plums, examine them once a month or so after a warm shower, any lumps, any little grain of sand, any anything within the testicle itself, get it sorted.
For more amusing top tips on your sexual health I would recommend Sex, Sleep or Scrabble, available at all major outlets, and of course a visit to the website, which has a whole wealth of information about embarrassing problems. See you soon.
Dr Phil Hammond is a medical doctor, comedian and commentator on health issues.

Written by: Dr Phil Hammond
Edited by: Dr Phil Hammond
Last updated: Thursday, October 26th 2017

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Comments on this article

Posted by David on 05/09/2017 at 03:04

I know you say you cannot answer questions but I'd really like a reply. When I was younger, (in my 40's or thereabouts) veins on the surface of my scrotum would sometimes bleed, especially after a shower. I have always assumed this was because the water in the shower was too hot. But this wasn't always the case. It hasn't happened for a long time now. But today it has happened and also today my scrotum is quite painful and retracted. It has bled quite a lot today. Stopped now. But scrotum is still sore. The shower was not very hot. But the weather has been very cold. I had a vasectomy when I was 35. Any ideas why this is happening??? Thanks David

Posted by Optional on 19/05/2017 at 06:05

Found a floating pea size ball in ball bag....not attached to testicle. . Floats around. ....little bit sore

Posted by Optional on 10/12/2016 at 12:02

good tips. men if you are worried go to the gp, and dont forgot to check once per month

Posted by stevenOptional on 09/09/2015 at 11:40

Hi I have what seems to be something coming of my right testical. Almost like a extra one but a quarter of the size. Had a sonogram or whatever it is called 10 years ago. Told me all was good. But never told me what it was. Can you help with that

Posted by Bigby w. on 29/07/2015 at 01:15

Hi I'm a normal guy with an active sex life… for about 10 yrs now or better I've had this problem... It doesn't seem to make much difference if I have soft gentle sex, masturbating, or having rough vigorous sex. The result is always the same. My cords swell up to almost the same size as my testicles causing extreme pain and discomfort. Idk what it is, or why it happens… feedback please!

Posted by Optional on 25/05/2015 at 10:04

Hello there. I am a 15 year old boy and am struggling with a lump not directly on the testicle, but on the inner side of the scrotum. It's about pea sized with a bit of a tube attached to th back almost like a vein. Please help!

Posted by Optional on 30/04/2015 at 04:36

My husband is 52 and has started to have hard lumps in the sac but not attached to the testicle or moving they are also in the crease between the legs and come and go. plus he has trouble with going for a pressure. is this all related at the same time he has a constant red spotty rash on on hand. he wont go to a doctor. help im worried as we lived in africa for a while and he was unfaithful.

Posted by isaac on 22/04/2015 at 07:46

my scrotum is changing... as if is dividing into two part...and please can this effect the tongue

Posted by Optional on 20/02/2015 at 09:08

Hello there, I noticed a free moving oval shaped lump roughly 1 cm long, and 2-4 mm side ways. This was noticed about a few months ago, but I took no notice. There is no pain on contact, and the texture is very soft. It has caused me no pain at all, but I would like more information on what it could be, and if I should go to my GP/doctor, or just keep an eye on it. I would really appreciate help towards this, thanks

Posted by Optional on 20/02/2015 at 02:31

hey my right testicle has a firm round ball at the top right edge it doesn't freely move around the scrotum but its not a mass on the testicle just barely connected it hurts on and off and sometimes days without pain been checked for epidymititus or something thought it was took the pills didn't go away what could it be im low on money so an expert opinion in dummy terms would be appreciated

Posted by Wayne B on 12/02/2015 at 06:46

Great information presented in a really relaxed and easy way. Has put my mind at rest about a few things. Well done Dr. Phil!

Posted by Abdulilah on 02/02/2015 at 08:41

I got something on my penis like grain and I'm scared of it. What should i do or use in that case to make it disappear and should i worry about it? Please let me know what's the solution for it. I hope to hear from you soon. Thank you,

Posted by CJG on 24/01/2015 at 02:47

I discovered a pea size lump in my testicle.It is not painful but I'm worry because I don't know whether there's a doctor in my country who can help me. Can I have sexual intercourse with my wife?

Posted by darryl on 29/12/2014 at 01:58

I have had a pea sized lump on the top of my right testicle for about 4 years and to scared go quack what u think

Posted by Help me on 08/11/2014 at 10:20

Dr Phil, please help me. I cannot tell my parents or share it with anyone as it is too embarrassing. I have pea sized ball in my scrotum which sometimes feels like a third testicle and can freely move in my entire scrotum, sometimes its around right testis and sometimes its around left testis. When i try to press it, to learn what's it freely moves around my scrotum. I noticed it around three years ago, the size of it has not changed much(maybe same at all). Is it of concern?? I am very scared!! Please do reply!

Posted by Optional on 16/09/2014 at 05:13

i didnt get what i wause look for mine goes the size of quater and then goes away?

Posted by Luke on 27/06/2014 at 03:04

I have a knot on the outter top of my left testical.. I found this knot nearly a year ago. And in the last 6 months it ststarted to get painful. Now the pain is quite noticeable aand painful.. I was hoping it would go away but it doesn't seem to be.. I don't have Heath insurance I really can't offord it.. I had an ultrasound and they said my testicals look normal, but to see a urologist. The er visit was 1000 bucks.. I was just wonderingg if I have waited to late or what?? I am currently working on trying to get heath insurance. I am just trying to get some insight on what is wrong with me

Posted by Optional on 23/06/2014 at 01:56

Right beside my testicals I have what looks like a vein that has popped out in the last few days and it hurts to touch but seams to be their still been 3 days now and also a lump in my right nipple that has a lot of pain all started to happen over the last 3 days what is happening I am very healthy every time I go to the doctors and can't afford to go back unless it is very serious

Posted by stevie on 09/06/2013 at 12:21

for the past few years i have had "spots" around my anus area, occasionally sore to touch but once in a while not.they can be squeezed like a spot and disappear soon i have one on right side of scrotum not only that, but pain feels dull and throbbing from right led joint. walking about other day and i felt spot burst! relief was great but i stiff feel tender around scrotum.

Posted by Optional on 22/03/2013 at 09:27

When I stood up the other day I had immediate pain in my left testicle. Heat helped and the pain went away for a day. The pain came back and now I have a lump on the top of my left testicle and it is very painful what could this be? I am 43.

Posted by Optional on 09/12/2012 at 12:55

I have a pea size lump on the side of my testicles.There is no pain and should i worry or not.Did i perhaps contracted a disease as my wife admitted sleeping with other men.What will your recomendation be.Thank you.

Posted by andre on 25/11/2012 at 01:22

Hi my name is Andre I've recently found a pea size lump on my testicle it is in no pain should I worry or not . Thank you

Posted by Darren on 23/02/2012 at 06:56

Hi, I wonder if you can shed some light for me. I recently had ct scan done and they found a 6mm high density lump in my scrotum. I was referred for an ultrasound. I went ct report in hand to the uss. 50 mins later and 1 radiologist and a sonography later and they can not find anything!! I do have a hard hair follicle on my penius, which measurers abbot 6mm. Do you think they might have seen this on the ct and thought it was in my scrotum. I know my penius as over the right side of the scrotum, What do I do next... I was and still worried I had cancer!!! Thanks

Posted by Optional on 09/07/2011 at 02:52

i am realy worried about my penis and testicles becouse my penis has small white lumps a little bit less then a millimetre all around the bottom of my penis and around my testicle sack! also my penis is bent and is probably 20% bent to the left :S not only that i feel something around my left testicle witch im not sure what it could be + my left testicle is a bit heavy and bigger the the right please help i am really worried and dont no what to do as i am only 13 ??? !!!!

Posted by Optional on 28/05/2011 at 04:14

this is a purplish sack within the veiny area about the right testicle, which seems to be made up of the veins in a knot. it is extremely tender, even to the touch.

Posted by William on 26/02/2011 at 11:26

I have a lot of sweating and sticky fluid around my scrotum what is very uncomfortable at night times by itching. Been to the Dr and had scan, was told that I have two cysts on my tubes, he gave me Daktacort, OK stops the itch for a while but dont seen to help with restless nights. Regards William.

Posted by Optional on 12/12/2010 at 11:06

Hey, thanks for the information. Found a grain of sand sized lump on my left testical, and was wondering if that was big enough to bother the doctor with. Might be nothing, but from what you've said I've decided to get myself checked out early rather than to wait and see. thanks

Posted by bruno on 15/10/2010 at 10:12

i just wanted to know if hmg could help me grow bigger testicles i have not been ever on steroids but i have small adult testicles just would like to have them fuller i have 23million sperm

Posted by anwar ashraf on 04/08/2010 at 08:47

hello sir, Two year before my right testis torisioned and made it correct by a sugery. I want to know a detailed explanation of those surgeries and its side effects.

Posted by maah on 17/06/2010 at 10:57

i hate ihave one testicle i cant show women when i make sex

Posted by Wayne F on 15/06/2010 at 05:49

About 20 years ago I had surgery on my testis on one side the Dr. said I had vericocele and on the other hydrocele, I had a very painful and difficult recovery. 10-15 years later..I was in a couple of auto accidents and got groin herina surgery with mesh. After this surgery I developed cronic pain in testis. I have had it looked at by 6 Uroligists ( ultrasound was done many times )and 4 nuroligists ( MRI's and cat scans ) they all claim it is due to lower back pain/ nerve damage that radiates to my scrotum. I think they all come to this conclusion because they are piggybacking their opionins on prior examinations. I have to self inject numbing medication 20CC 2x daily opiod medications help by don't help by themselves. Problem is this... I have a slowly enlarging HARD lump in my sac and outside my testis it appears to be on the surface of the testis and does not float I think it changes from a pea size to a grape size and is very very very tender...because it is tender I insist it is related to the overall pain issue. Even though I know the post surgery issues I would have to deal with. I would like it removed and if need be the testis and sacs can go as well as long as I don't lose sexual function, I am not interested in children but i would like my life back and believe this would help. I do have back problems from S1 though to C2 but this pain is managed with medications for the most part. What would you suggest? What would you guess the real problem is? Also note after sexual arousal it hurts more for days afterward so I have to be wary of any arousal, this is near impossable I have tried sex and do get normal erection but the pain afterward is a 10/10 which confines me to bed with ice packs. I have tried to asperate the lump myself( talk about pain!!! ) it appears not to be purely fluid I didn't get anything with draining with a very fine needle. I tried larger needles and still nothing!